Provider Demographics
NPI:1275559296
Name:BABE, RODNEY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:SCOTT
Last Name:BABE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2264 MCGILCHRIST ST SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1187
Mailing Address - Country:US
Mailing Address - Phone:503-581-7700
Mailing Address - Fax:503-581-7799
Practice Address - Street 1:2264 MCGILCHRIST ST SE
Practice Address - Street 2:SUITE 100
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1187
Practice Address - Country:US
Practice Address - Phone:503-581-7700
Practice Address - Fax:503-581-7799
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD219722084P0800X, 2084P0015X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR026508Medicaid
OR026508Medicaid
ORR139698Medicare PIN
OR026508Medicaid